单中心晕厥患者临床资料分析  

Single-center clinical data analysis of syncope patients

作　　者：陈美凤 田海萍[2] 聂慧娟[2] 郑海英[2] 赵艳春 CHEN Meifeng;TIAN Haiping;NIE Huijuan;ZHENG Haiying;ZHAO Yanchun(Department of General Internal Medicine,The Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot,010020,China;Department of Cardiology,Affiliated Hospital of Inner Mongolia Medical University;Department of ECG Room,Inner Mongolia Autonomous Region People's Hospital)

机构地区：[1]内蒙古医科大学第二附属医院综合内科,呼和浩特010020 [2]内蒙古医科大学附属医院心内科 [3]内蒙古自治区人民医院心电图室

出　　处：《临床心血管病杂志》2023年第5期394-399,共6页Journal of Clinical Cardiology

基　　金：内蒙古自治区卫生健康科技计划项目(No:202202186);内蒙古自治区自然科学基金项目(No:2020MS08142)。

摘　　要：目的:对单中心晕厥患者临床资料进行分析,探讨晕厥患者的临床特点和预后情况。方法:本研究共纳入研究对象505例,包括2019年1月—2021年1月于内蒙古医科大学附属医院门诊或住院诊断为“晕厥”的患者363例,以及通过纸质版和电子版问卷进行调查,收集调查问卷142例。收集患者的临床基线资料,通过电话随访方式,在第1、4、8和12个月收集数据,对其疾病进展和发生的事件进行1年的监测。结果:①505例患者中,男257例(50.9%),平均年龄(55.52±17.23)岁,平均首次发作年龄(52.30±19.45)岁,中位发作次数1.00次(1.00,2.00)次。333例(65.9%)有诱因,以体位改变最常见,347例(68.7%)有晕厥前兆,最多见的为头晕。②最常见的晕厥为反射性晕厥222例(44.0%),反射性晕厥中最常见的为血管迷走性晕厥183例(82.4%);第二常见的为心源性晕厥123例(24.4%),以缓慢性心律失常晕厥最常见58例(47.2%);其次为直立性低血压晕厥22例(4.4%)。最终有138例(27.3%)晕厥原因仍未明确。③反射性晕厥患者中存在晕厥前兆的比例高于不明原因晕厥患者的比例,差异有统计学意义(P<0.001)。反射性晕厥患者存在晕厥诱因的比例显著高于心源性晕厥和不明原因患者的比例,差异有统计学意义(P<0.001)。④采用logistic回归分析探讨不明原因晕厥的影响因素。结果表明,首次发病年龄偏大,合并脑血管用药者中,以不明原因晕厥居多。在大多数有晕厥先兆、诱发因素和伴发心律失常的患者中,晕厥的病因可以确定。⑤对入选患者进行电话随访,共随访245例(606人次),平均随访时间(8.11±3.46)个月,210例(85.7%)结局良好(未复发),28例(11.4%)晕厥复发,4例(1.6%)因晕厥而摔伤,16例(6.5%)再次就诊于门诊,18例(7.3%)再次住院治疗,4例(1.6%)死亡。心源性晕厥结局良好的比例低于反射性晕厥和不明原因晕厥,差异有统计学意义(P<0.05),心源性晕厥再住院的比例高�Objective To analyze the clinical data of patients with syncope in a single center and to discuss the clinical characteristics and prognosis of syncope patients.Methods A total of 505 subjects were included in the study,including 363 patients diagnosed with"syncope"in the outpatient or inpatient department of the Affiliated Hospital of Inner Mongolia Medical University from January 2019 to January 2021.A total of 142 questionnaires were collected through the questionnaire survey in both paper and electronic versions.Clinical baseline data were collected for enrolled patients and data were collected over the telephone at 1,4,8,and 12 months,followed by 1-year monitoring of disease progression and events.Results①Among the 505 patients,there were 257 males(50.9%),with an average age of(55.52±17.23)years,an average age of the first episode of(52.30±19.45)years,and the median number of episodes 1.00(1.00,2.00)times.333 cases(65.9%)had predisposing factors,and posture change was the most common.347 cases(68.7%)had a precursor of syncope,and the most common was dizziness.②The most common syncope was 222 cases(44.0%)in reflexsyncope and 183 cases(82.4%)in reflexsyncope with vasovagal syncope.Cardiogenic syncope was the second most common in 123 cases(24.4%),and bradyarrhythmia syncope was the most common in 58 cases(47.2%).This was followed by 22 cases(4.4%)of orthostatic hypotension syncope.In 138 cases(27.3%)the cause of syncope is still unclear.③The proportion of patients with syncope precursor in reflexsyncope was higher than that of patients with unexplained syncope,and the difference was statistically significant(P<0.001).The proportion of patients with syncope precipitating factors in reflexsyncope was significantly higher than that of patients with cardiogenic syncope and unexplained syncope,and the difference was statistically significant(P<0.001).④Logistic regression analysis was used to explore the influencing factors of unexplained syncope.The results showed that the older the patient was for the fi

关 键 词：单中心 晕厥 临床资料 

分 类 号：R741[医药卫生—神经病学与精神病学]